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32C-206 (8) For the pantry on the first floor. • To finish installing the sheetrock, after the framing is completed. • The pantry will receive a three coat tape job • The sheetrock will be sanded. For the second floor walls and ceilings * To install 1/2" sheetrock over the wood lathing after the plaster is removed by the owner. • The new sheetrock will receive a three coat tape job • The ceilings and the walls will be sanded. • Any openings wrapped with sheetrock and corner bead instead of wood casings will be done for an extra charge of $ 90.00 per opening. * The owner will be responsible for, finishing the framing in the pantry on the first floor, covering the existing floor finish on the second floor and removing the plaster on the second floor, before the job is started. If you would like help with these areas of the project please contact us for additional pricing. Please Note: Once the proposal is signed the project will go into the job schedule and you will be given an approximate start date. This date can fluctuate based on the time involved to complete the projects entered into the schedule before you. Two days before the actual start of the project you will be notified by phone. This project will take approximately 12-14 days to complete. The rooms to be worked in will need to be totally cleaned out and the ceiling and wall fixtures removed before the work can begin. Any areas not ready with the rest of the job, requiring extra trips to the job by any of the crews, will be charged as an extra. When covering and protecting the existing finishes there is always a possibility that the finishes will be damaged by the masking tape we accept no responsibility if this damage should occur, please sign the disclaimer below. DISCLAIMER: We do not hold N. R. Bergeron Drywall Contractor, Inc. or its employees or representatives liable for any damage to the existing finishes. SIGNATURE DATE RIGHT OF CANCELLATION: Do not sign this section unless you want to cancel this proposal. You have the right to cancel this contract at any time with in three days of the signing date. To cancel phone notification is requested, followed by the returning of your copy of the proposal signed and dated below. SIGNATURE DATE 2 N.R. BERGERON DRYWALL CONTRACTOR, INC. 1106 EAST MOUNTAIN ROAD WESTFIELD MASSACHUSETTS 01085 PHONE: (413)568-0962 MA HIC #: 1037�j1'8 CT HIC #: 603077 PROPOSAL SUBMITTED TO 1I( //0 PHONE DATE Larry Brotherton 413-695-7199 06/03/2009 STREET CITY STATE ZIP 1 Kary Street Northampton MA 01060 JOB NAME: 2nd floor walls and ceilings JOB LOCATION: Same address as listed above. WE PROPOSE TO FURNISH MATERIALS AND LABOR FOR THE SUM OF: Three thousand five hundred twenty dollars ($3,520.00) PAYMENT TO BE MADE AS FOLLOWS: All invoices are due and payable upon receipt. 50% when the materials are ordered $1, 760. 00, 20% when the hanging is started $704 .00, 20% when the taping is started $704 .00, 10% when the project is completed $352.00. All material is guaranteed to be as specified. All work will be completed in a workmanlike manner according to standard practices.Any alterations or deviations from the specifications listed below involving extra costs will be executed only upon written change orders, and will become an extra charge over and above the estimate. All agreements contingent upon strikes, accidents or delays beyond our control. Owner to carry fire, tornado and other necessary insurance. Our workers are fully covered by Workman's Compensation Insurance. This price is guaranteed for a period of thirty days, except as noted below, after that time any changes in material costs or labor costs will automatically to be added to the estimate. All invoices are due and payable upon receipt. Any missed payments will constitute a reason for stopping the work on the project. Any balance remaining unpaid 30 days after the billing date will be subject to a service charge of 1 1/2 % per month. In the event of default or non-payment you hereby agree to pay all reasonable costs of collection including, but not limited to, all attorneys fees and expenses. AUTHORIZED SIGNATURE: &116tejA.Xft DESCRIPTION OF WORK: The description of all work to be performed under the proposal is listed on page 2. Please see page 2. ACCEPTANCE OF PROPOSAL: The prices, specifications and conditions set forth in this proposal are satisfactory and are hereby accepted. You are authorized to do the work as specified. Payment will be made as specified above. SIGNATURE DATE SIGNATURE DATE Please sign and return one copy. Thank you for the opportunity to do your work. DESCRIPTION OF WORK: 1 HOME OWNER EXEMPTION ACKNOWLEDGEMENT The State of Massachusetts allows the homeowner the right under 780CMR 108.3.4 to act as his/her construction supervisor. The state defines "Homeowner" as, "Person(s) who owns a parcel on which he/she resides or intends to be, a one or two family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a home owner." The building department for the City of Northampton wants person(s)who seek to use the home owner exemption, to act as their own construction supervisor, to be aware that by doing so you become responsible for compliance with state building codes and regulations. The inspection process requires that the building department be called to inspect work at various stages, which include foundation/footings (before backfigh sonotube holes (before pour) a rough building inspection (before work is concealed), insulation inspection (if required)and a final building inspection. The building department requires these inspections before the work is concealed, failure to secure these inspections can result in failure to obtain a certificate of occupancy until the work can be inspected. If the homeowner hires other trades to perform work(electrical, plumbing&gas)the homeowner will be responsible to make sure that the trades hired secure their proper permits in conjunction to the building permit issued, and that they get their required inspections.Failure of the individual trades to secure the permits and inspections as required can DELAY the project until such time as the proper permits and inspections are made I, understand the above. (Home owner/resident's signature requesting exemption) I will call to schedule all required building inspections necessary for the building permit issued to me. Date 'r q Address of work location - .� lov r> The Commonwealth of Massachusetts Department of Industrial Accidents Office bf Iizvestigations �. 600 f1'ashington Street Boston, MA 02111 www.tnass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/EIectricians/Plumbers Applicant Information Please Print Legibly f ? Name(Business/Organization/Individual): _ Address: b:: —P City/State/Zip: Phone#: QI Li Are you an employer?Check the appropri to bon: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I 6. ❑New construction employees (full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have S. ❑ Demolition working or me in an capacity. employees and have workers' g y p t5'- 9. ❑ Building addition [No workers' comp.insurance comp. insurance.$ required.] 5. ❑ We are a corporation and its 10.F-1 Electrical repairs or additions 3'�X I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.0 Roof repairs. insurance required.]t c. 152, §1(4),and we have no employees. [No workers' 13.❑ Other comp. insurance required.] "Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. ,Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic. #: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties ofperjury that the information provided(!/,/above is true and correct. Signature Date: �l /(1 ea Phone#- �/ / / ! Of use only. Do not write in this area, to be completed by city or town official Citv or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder: License Number Address Expiration Date Signature Telephone 9. Regisrtered'Horhe Im6rovern6 Fact Not Applicable ❑ Company Name Registration Number Address Expiration Date Telephone SECTION 10-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.152,§'256(6)) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed Affidavit Attached Yes....... ❑ No...... ❑ 11. Home Dvnerzge � on' The current exemption for"homeowners"was extended to include Owner-occupied Dwellings of one(1) or two(2)families and to allow such homeowner to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor.CMR 780, Sixth Edition-Section 108.3.5.1_ Definition of Homeowner:Person(s)who own a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official,on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. As acting Construction Supervisor your presence on the job site will be required from time to time,during and upon completion of the work for which this permit is issued. Also be advised that with reference to Chapter 152(Workers'Compensation) and Chapter 153(Liability of Employers to Employees for injuries not resulting in Death)of the Massachusetts General Laws Annotated,you may be liable for person(s) you hire to perform work for you under this permit. The undersigned"homeowner"certifies and assumes responsibility for compliance with the State Building Code,City of Northampton Ordinances, State and Local Zoning Laws and State of Massachusetts General Laws Annotated. Homeowner Signature �� SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House ❑ Addition ❑ Replacement Windows Alteration(s) Roofing ❑ Or Doors Accessory Bldg. ❑ Demolition New Signs [0] Decks [Q Siding[E-1] Other[O] Brief Description of Proposed Work: ��^c��r Alteration of existing bedroom Yes 64 No Adding new bedroom Yes X No of Attached Narrative Renovating unfinished basement Yes No x Plans Attached Roll -Sheet 6a. If New house and or.addition to-existinq housing;complete the following: a. Use of building: One Family Two Family Other b. Number of rooms in each family unit: Number of Bathrooms c. Is there a garage attached? d. Proposed Square footage of new construction. Dimensions e. Number of stories? f. Method of heating? psclscck or odstoves Number of each g. Energy Conservation Compliance. Mass rgy Compliance form attached? h. Type of construction i. Is construction within 100 ft. of wetlands? nstruction within 100 yr. floodplain Yes No j. Depth of basement or cellar floor below fik. Will building conform to the Building and Yes No. I. Septic Tank City Sewer Private well City water Supply SECTION 7a-OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING.PERMIT 1 as Owner of the subject property hereby authorize to act on my behalf,in all matters relative to work authorized by this building permit application. Signature of Owner Date as Owner/Authorized Agent hereb eclare that t statem nts and information on the foregoing application are true and accurate,to the best of my knowledge and belief. Signed under the pains and penalties of perjury. I Print Name Signature of Owner/Agent Date Section 4. ZONING All Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information Existing Proposed Required by Zoning This column to be filled in by Building Department LotSize __._,. . ,,,,._... ......... ......_. .,._...__,.,.... Frontage Setbacks Front Side L:<._. ,_,_ : R. _.,._. _. L R:,-, Rear Building Height Bldg. Square Footage % Open Space Footage ° -°°-- (Lot area minus bldg&paved parkin #of Parking Spaces Fill: (volume&Location) A. Has a Special Permit/Variance/Finding ever been issued for/'on the site? NO 0 DONT KNOW YES IF YES, date issued:: IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DONT KNOW YES IF YES: enter Book Page and/or Document# B. Does the site contain a brook, body of water or wetlands? NO 0 DONT KNOW YES 0 IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Obtained , Date Issued C. Do any signs exist on the property? YES NO IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property? YES 0 NO IF YES, describe size, type and location: E. Will the construction activity disturb(clearing,grading,excavation, or filling)over 1 acre or is it part of a common plan that will disturb over 1 acre? YES 0 NO IF YES,then a Nofthampton Storm Water Management Permit from the DPW is required. Department use only, City of Northampton Statue of Permit Building Department Cuib Cu#tr1 ewayPerrntt M 212 Main Street SevirerlSeptrcAvaitabtltty Room 100 WateriUlrell.AyalfaJ7�I�ty k Northampton, MA 01060 Twa Sets of S#ructt rat Plans phone 413-587-1240 Fax 413-587-1272 Plot/Sr#e PJans- Ot)er�peafy APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION This section to be completed by office 1.1 Property Address: Map Lot Unit ' Zone Overlay District Elm St District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT' 2.1 Owner of Record: - I � t Name(Pr Current Mailin g Add�reDs2 A 7 Telephone Signature 2.2 Authorized Agent: Name(Print) Current Mailing Address: 1 Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only com feted by ermit applicant 1. Building 100 I, (a)Building Permit Fee 2. Electrical V (b)Estimated Total Cost of Construction from 6 3. Plumbing Building'Permit'Fee 4. Mechanical(HVAC) 5. Fire Piulecliun 6. Total=(1 +2+3+4+:5 Check Number This Section For Official Use Only Date Building Permit Number: Issued: Signature: Building Commissioner/Inspector of Buildings Date File#BP-2009-1048 APPLICANT/CONTACT PERSON SCHIFFER ELYENA ADDRESS/PHONE 1 KARY ST NORTHAMPTON (914)629-2764 Q PROPERTY LOCATION 1 KARY ST MAP 32C PARCEL 206 001 ZONE URC(100)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out Fee Paid Typeof Construction: REMOVE PLASTER IN 2 ROOMS New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included• Owner/Statement or License 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFO MATION PRESENTED: N66b5- P6rz ,i �Q1MEr�W D ���- SNE TRH L Approved Additional permits required(see below) C-A �1 PLANNING BOARD PERMIT REQUIRED UNDER:§ Intermediate Project: Site Plan AND/OR Special Permit With Site Plan Major Project: Site Plan AND/OR Special Permit With Site Plan ZONING BOARD PERMIT REQUIRED UNDER: § Finding Special Permit Variance* Received&Recorded at Registry of Deeds Proof Enclosed Other Permits Required: Curb Cut from DPW Water Availability Sewer Availability Septic Approval Board of Health Well Water Potability Board of Health Permit from Conservation Commission Permit from CB Architecture Committee Permit from Elm Street Commission Permit DPW Storm Water Management Demolition Delay 06 23o2 Signature of Building Official Date Note: Issuance of a Zoning permit does not relieve a applicant's burden to comply with all zoning requirements and obtain all required permits from Board of Health,Conservation Commission,Department of public works and other applicable permit granting authorities. *Variances are granted only to those applicants who meet the strict standards of MGL 40A. Contact Office of Planning&Development for more information. 'I VAR BP-2009-1048 #' GIs#: COMMONWEALTH OF MASSACHUSETTS m 12-2 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: BUILDING PERMIT Permit# BP-2009-1048 Protect# JS-2009-001519 Est.Cost: $1000.00 Fee: $55.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: NR BERGERON DRYWALL CONTRACTOR INC 103718 Lot Size(sq.ft.): 3702.60 Owner: SCHIFFER ELYENA Zoning URC(100)/ Applicant: SCHIFFER ELYENA AT. 1 KARY ST Applicant Address: Phone: Insurance: 1 KARY ST (914) 629-2764 O NORTHAM PTONMA01 060 ISSUED ON:612312009 0:00:00 TO PERFORM THE FOLLOWING WORK.-REPLACE PLASTER IN 2 ROOMS ENLARGE BATHROOM & CLOSET POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector Underground: Service: Meter: Footings: Rough: Rough: House# Foundation: Driveway Final: Final: Final: Rough Frame: Gas: Fire Department Fireplace/Chimney: Rough: Oil: Insulation: Final: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Certificate of Occupancy Signature: FeeType• Date Paid: Amount: Building 6/23/2009 0:00:00 $55.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo